AMERICAN ASSOCIATION OF DIABETES EDUCATORS
Education and Research Foundation
2012 REQUEST FOR PROPOSALS
CONTINUOUS QUALITY IMPROVEMENT GRANT
The AADE Education and Research Foundation is offering a grant of up to $20,000, for a one-year continuous
quality improvement (CQI) study/project in the field of diabetes education, with a focus on behavior change and
goal setting related to medication adherence and monitoring. The funding will support an award to an accredited
diabetes self-management training (DSMT) program that will plan and implement Continuous Quality
Improvement (CQI) project. The goal is to support a project that 1) improves the quality of care to patients with
diabetes and leads to improved patient outcomes, and 2) results in the development of CQI processes that can be
adopted by other DSMT programs in a wide variety of settings. The aim of this program is not only to support a
specific DSMT program in developing and implementing a CQI project that impacts patient outcomes, but to
support a nationwide network of DSMT programs in meeting standards for accreditation, making their programs
more efficient, and providing quality patient care.
As of June, 2011, AADE has accredited 334 programs operating out of more than 900 individual sites in a variety of
settings. The programs that AADE accredits for DSMT are each required to submit to AADE annual status reports
that are used to assess their progress and compliance with the National Standards. AADE also surveys the
programs each year to gather information about their experiences and their need for resources and support.
Through these reports and surveys, AADE has learned more about the Standards that programs find most
challenging. One of the Standards that programs have cited as being challenging is Standard 10, which requires
that programs measure the effectiveness of the education process and determine opportunities for improvement
through a Continuous Quality Improvement (CQI) plan. AADE’s most recent survey of DEAP programs has
indicated that 65% of programs seek additional education and support on CQI.
CQI, as applied to the National Standards, is defined as a process consisting of a series of steps designed to
enhance DSMT and improve patient and program outcomes. Steps include identifying opportunities for
improvement, collecting and analyzing data, choosing an approach, developing concepts and processes,
implementing a plan, evaluating the plan, and maintaining the improvement. CQI is important to the field of
diabetes education, not only because it is a required standard, but because it has implications for optimizing the
practice of DSMT and ultimately improving patient outcomes. DSMT programs’ ability to operate effectively and
efficiently becomes even more important as the incidence of diabetes continues to rise. CQI gives programs a
framework for examining program processes and making refinements and corrections that will help them better
meet the needs of their patients.
AADE recognizes that CQI must be planned and implemented based on each program’s goals, gaps, and patient
needs. AADE also recognizes that, although DSMT programs are varied in target population and practice setting,
they are united in their focus on the AADE7 self-care behaviors (healthy eating, being active, monitoring, reducing
risks, medication taking, problem solving, and healthy coping) and working toward the outcome of positive
behavior change in the patients that they serve. In order to have the greatest impact, AADE will support projects
that address the use of CQI to improve behavior outcomes since behavior change is a goal shared by all DSMT
programs and there are numerous aspects of behavior change can be explored and addressed through CQI.
One of these aspects of behavior change in DSMT is goal-setting. Both diabetes educators and patients have
varied approaches to goal-setting (Malemute et al, 2011; Zgibor et al, 2007). For example educators and patients
may be more likely to identify goals for healthy eating and being active, but less likely to develop goals for
monitoring and taking medication even though these behaviors can be vital to maintaining glycemic control
(Zgibor et al, 2007). Although patient goal-setting is an important part of DSMT and mutually identified behavior
change goals among educators and patients may improve targeted educational strategies to support patients in
meeting their goals (Zgibor et al, 2007), little is known about how the goal-setting process takes place and how it
can be improved to impact behavior change and clinical outcomes. Of particular relevance is goal-setting and
positive behavior change related to medication adherence, as the prescribed medication regimen for diabetes
treatment can be quite complex for some patients and individual patients may face a diverse set of barriers to
General Requirements for a project/study of CQI initiatives relating to behavior change and goal-setting related
to medication adherence and/or monitoring within a DSME/T program:
For this grant, applicants are encouraged to:
Design a plan to measure and evaluate the results of the project based on the parameters of the study
Provide a brief needs assessment or literature review.
Describe a fully replicable study/project design and state specific goals, objectives, and activities that will
be undertaken. Pilot studies are acceptable.
Demonstrate familiarity with tools that facilitate data collection and CQI efforts. AADE currently
recommends use of electronic data collection systems (e.g., AADE7 System available at:
http://www.diabeteseducator.org/professionalresources/AADE7/A7S.html) and graphical
representations such as affinity and fishbone diagrams that may be incorporated into CQI efforts.
Submit a detailed timeline and budget. The proposed project should be one that can be completed in a
12-month time period.
Application Deadline: Proposals are due by Friday, August 17, 2012.
Specific Application Requirements
The principal investigator must be employed by or have a close affiliation with an AADE Diabetes Education
Accredited Program (DEAP) and have demonstrated interest, expertise and productivity in the field of diabetes
care. Further, the applicant must have access to patient population and programs or sites where diabetes
education is delivered. Preference will be given to applicants that are AADE members, membership in AADE is
encouraged. Proposed CQI projects must be well described and replicable. Specific goals, objectives, and activities
will be generated by the proposal applicant.
Abstract: An abstract of no more than 150 words should summarize the proposal in language that is
understandable by the general public.
Project Narrative (six-page limit)
The proposal narrative is limited to six pages of text, single-spaced with font size no smaller than 12 point. The
Project Narrative includes the following:
Specific Aims and Outcomes. Describe the specific aims and the intended objectives of the proposed project,
including your specific study question that is related to CQI. The study question must address: 1) outcomes of a
DSMT program; and 2) patient outcomes related to DSMT.
Significance. Explain the importance of the project to the field of diabetes education, and how the CQI efforts will
be used to improve DSMT programs and behavioral and clinical outcomes. Include a literature review and needs
assessment that provides background information relevant to the project and a brief evaluation of the existing
body of knowledge related to your study question.
Methods and Timetable. Describe the population to be served, and the study design and intervention(s) that will
be used to carry out the project. Identify the study sample (including a power analysis, if applicable), site, and the
variables that will be tested and measured. Specify the instruments that you plan to utilize to collect data,
including a description of their validity and reliability. Include copies of the instruments with your proposal.
Describe your study protocol (how you plan to collect data) and your plan for analyzing data. Include a proposed
timeline for your study; the proposed project should be able to be completed within a 12-month period. Describe
how project results will be disseminated and shared. Discuss how the project will be sustained upon completion
of the study.
Budget. Provide an itemized budget for all costs requested and a justification that explains how the costs were
calculated and how the costs are directly related to the project. Funds will be awarded to the institution with
which the Principal Investigator (PI) is affiliated and not directly to the PI. Indirect costs, capital improvements,
computer purchases, and travel that is not directly related to implementation of the study will not be supported.
Investigator Qualifications. Provide a biosketch or resume for the Principal Investigator (PI), and all key
personnel and consultants who will be responsible for carrying out the proposed project. Provide a brief narrative
overview of the PI’s experience related to diabetes care and diabetes education, as well as their prior experience
carrying out project(s) similar in nature and scope. Briefly describe other team members’ experience relevant to
the proposed project.
Evidence of Institutional Review for Ethical Standards. Attach evidence that the proposal has been submitted to,
and reviewed and approved by an established Institutional Review Board (IRB) at the institution or site where the
project will be conducted. Approval may be pending at the time of submission of the application, but an approval
letter must be received by AADE Education and Research Foundation before any funds are allocated to the
Institutional Support. Include letters of commitment, indicating that the institution is supportive of the proposed
project and that the PI and their team will have access to the project site and proposed patient population.
(These are NOT included in the 6 page limit).
Submit the completed proposal and application form electronically by August 17, 2012
Please submit your application electronically in PDF or MSWord format to the following email address: